Provider Demographics
NPI:1609655802
Name:BRAZIL, ANNA CECELIA (DPT)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:CECELIA
Last Name:BRAZIL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 EAGLE DR
Mailing Address - Street 2:
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-4441
Mailing Address - Country:US
Mailing Address - Phone:707-272-1004
Mailing Address - Fax:
Practice Address - Street 1:23655 VIA DEL RIO STE C
Practice Address - Street 2:
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92887-2718
Practice Address - Country:US
Practice Address - Phone:714-695-1566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA304930225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist